上腔静脉滤器在肿瘤合并上肢深静脉血栓形成中的应用

Superior vena cava filter placement for cancer patients with upper extremity deep vein thrombosis

目的:探讨应用上腔静脉滤器对肿瘤合并上肢深静脉血栓形成患者预防肺栓塞发生的安全性和有效性。方法:回顾性分析20例上肢深静脉血栓形成患者资料。20例患者中肺癌6例,胃癌4例,乳腺癌2例,卵巢癌、胰腺癌、鼻咽癌、白血病、恶性淋巴瘤、食管癌、贲门癌、胸腺瘤术后左颈部转移各1例。其中9例患者行PICC(Peripheral inserted central catheter)置管化疗,2例行锁骨下静脉置管化疗。结果:全部患者均成功置入上腔静脉滤器,保留深静脉置管的患者术后成功拔除深静脉导管,无手术相关并发症发生,随访6～24个月,术后无症状性肺栓塞、上腔静脉穿孔、滤器移位及上腔静脉综合征发生。结论:恶性肿瘤及深静脉置管是上肢深静脉血栓形成最重要的原因,上腔静脉滤器置入是预防肿瘤合并上肢深静脉血栓形成患者发生肺栓塞的一种安全和有效的措施。

Objective： To discuss the safety and effectiveness of superior vena cava filter （SVCF） placement in cancer patients with upper extremity deep vein thrombosis （UEDVT）. Methods： Retrospective analysis of the data from 20 cancer patients with UED- VT was conducted. Of the 20 patients, 6 had lung cancer, 4 had gastric cancer, and 2 had breast cancer. The remaining eight cases were ovarian cancer, pancreatic cancer, nasopharyngeal carcinoma, leukemia, malignant lymphoma, esophageal cancer, gastric cardia cancer, and metastasis to the neck after surgery for thymoma. Results： The SVCF was successfully implanted in all patients. The deep-vein catheter was successfully removed from the patients who underwent deep venous catheterization without surgical complications. Com- plications such as post-operative asymptomatic pulmonary embolism, filter migration, and superior vena cava syndrome did not occur in any of the cases within the 6 months to 24 months of follow up. Conclusion： Malignant tumors and deep venous catheterization are the most important causes of UEDVT. SVCF placement is safe and effective in preventing pulmonary embolism in the cancer patients with UEDVT.